Sympathetic Ophthalmitis Following Adherent Leucoma: A Rare Association

Introduction: Sympathetic ophthalmitis is a rare condition. It occurs due to bilateral granulomatous pan uveitis following penetrating trauma or surgery in one eye. Penetrating injury to eye causes exposure of uveoretinal antigens to regional lymph nodes via conjunctival lymphatics thereby inciting delayed T cell hypersensitivity. Case Report: A 35-year-old male patient presented with headache and sudden painless dimunition of vision in both eyes preceded by development of adherent leucoma in left eye due to a perforated bacterial corneal ulcer five months before. Best corrected visual acuity was finger counting close to face in both eyes. Anterior segment examination revealed few keratic precipitates (KPs), 1+ cells and retrolenticular flare in both eyes. Fundus examination revealed exudative retinal detachment in right eye but left eye could not be assessed due to adherent leucoma. B-scan ultrasonography (B-scan) revealed exudative retinal detachment in both eyes. Patient was managed medically with intravenous methyl prednisolone 1 g for 3 days followed by oral steroids which led to complete resolution of disease process in both eyes. After treatment the best corrected visual acuity was 20/30 in right and 20/80 in left eye. Conclusion: Patients with adherent leucoma subsequent to a perforated corneal ulcer may remain at an increased risk of developing sympathetic ophthalmitis during their lifetime. However, timely medical intervention can lead to good visual prognosis for both exciting as well as the sympathizing eye. Long-term follow-up is necessary as recurrences following cessation of treatment are known to occur.

並列關鍵字

Sympathetic ophthalmitis ； Adherent leucoma ； Perforated corneal ulcer ； Exudative retinal detachment ； Methyl prednisolone

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